Active NPI
Seabay Dialysis LLC
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- San Bernardino, CA
National Provider Identifier
1306267364
On this page
Key facts
NPPES NPI Registry- Primary specialty
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Legal business name
- SEABAY DIALYSIS LLC
- Practice address
- 966 E Hospitality LN
San Bernardino, CA 92408-2818 - Phone
- (909) 796-8421
- Fax
- (909) 478-7547
- NPI assigned
- Dec 18, 2013
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Samuel T. Wey
- Title
- VP, Licensure & Certification
- Phone
- (615) 341-6641
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| End-Stage Renal Disease (ESRD) Treatment Clinic/Center | 261QE0700X | Primary |
Addresses
Primary practice location
966 E Hospitality LN
San Bernardino, CA 92408-2818
Mailing address
5200 Virginia Way
L&C Dept
Brentwood, TN 37027-7569
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306267364 | Medicaid | CA |
Other names 1
- San Bernardino Home Training
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20131231001642 | CA | Part A Provider - End-Stage Renal Disease Facility (ESRD) | 6800024514 | Practice locations: San Bernardino, CA |
Care Compare: Dialysis facility
Medicare Care Compare- Listed as
- DaVita San Bernardino Home Training
- Ownership
- Profit
- Certified
- Nov 10, 2014
- Medicare certification status
- Active
- Chain
- DaVita
Name & address match This facility record has no NPI; it was connected to this NPI by matching name and address.
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 05D2081176 | San Bernardino Home Training | Certificate of waiver | Jul 20, 2028 |
National Provider Directory
National Provider DirectoryMember of 1
Organizations this organization is a member of, according to the National Provider Directory.
-
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Burlington, WA
- NPI 1932595584
Member Of
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Mental Health Counselor
- San Bernardino, CA
- NPI 1538380225
Affiliated clinicians 7
Clinicians who list this facility as an affiliation in Medicare Care Compare.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1387324800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1775606400000",
"number": "1306267364",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5200 VIRGINIA WAY",
"address_2": "L&C DEPT",
"city": "BRENTWOOD",
"state": "TN",
"postal_code": "370277569"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "966 E HOSPITALITY LN",
"city": "SAN BERNARDINO",
"state": "CA",
"postal_code": "924082818",
"telephone_number": "909-796-8421",
"fax_number": "909-478-7547"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SEABAY DIALYSIS LLC",
"organizational_subpart": "NO",
"enumeration_date": "2013-12-18",
"last_updated": "2026-04-08",
"certification_date": "2026-04-08",
"status": "A",
"authorized_official_last_name": "WEY",
"authorized_official_first_name": "SAMUEL",
"authorized_official_middle_name": "T.",
"authorized_official_title_or_position": "VP, LICENSURE & CERTIFICATION",
"authorized_official_telephone_number": "615-341-6641"
},
"taxonomies": [
{
"code": "261QE0700X",
"taxonomy_group": "",
"desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1306267364",
"state": "CA"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "San Bernardino Home Training",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "San Bernardino Home Training",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in San Bernardino, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.